Healthcare industry is fast approaching a major milestone lead by advances in healthcare technology: Data driven evidence based decision making based on each patient’s individual needs. So far, the broader Healthcare industry; comprising healthcare providers, payers and life sciences mostly worked in silos. The traditional model consists of pharmaceutical firms developing drugs, healthcare providers prescribing the drugs and payers reimbursing for the drugs. Doctors typically diagnose (and prescribe) on the basis of only the patient’s phenotype (the physical characteristics), often supported by the clinical examination (subjective analysis), lab/radiology (objective analysis) results. Such treatment approach often takes no account of each person’s other major attribute: the genotype. One would hence argue that no proper diagnosis should be ‘complete’ without properly analysing the phenotype along with the genotype. This is precisely what personalized medicine promises to change, with a shift away from ‘one size fits all’ approach to a targeted personalized or precision medicine.
The following major developments make this approach possible now:
- Falling costs: In the 1990s it took more than a billion USD to sequence the human genome. That cost has now fallen astronomically to a few thousand USDs (and still falling) and fast approaching a few hundred USD landmark. Rapid advances in Big Data analytics technologies (See: Target Big Data to Gain Access to Future Strategic Leaders of Healthcare Systems ) offer quick data crunching facilities in a timely and cost effective fashion
- Adoption of Electronic Health Records across many health systems has created ‘access points’ from information technology apart from operational technology : Multiple countries have adopted nationwide Electronic Health Records projects. Nordic countries, Estonia, United States, England, Scotland, Singapore, and Australia are just some of the countries that have invested or have current ongoing initiatives in this area
- Government lead directive: Public agencies across some countries (most notably the UK) have ambitious plans to meaningfully mine information across Life Sciences and Healthcare data. UK’s 100,000 genome project aims to sequence 100,000 genomes of NHS patients by 2017 and there are on-going multi million pound initiatives for DNA sequencing of oncology (cancer) and rare diseases. The Clinical Practice Research Datalink (CPRD) in the UK (possibly world’s largest anonymous primary care data) contains data of > 13 Million patients and CPRD is working in collaboration with Medicine and Healthcare Products Research Agency (MHRA) to enable (possibly mine for information) use of this data. In Iceland, deCODE project was another big gene hunting project of its kind.
- Pay for Performance/ Value Based Reimbursement: Like Healthcare Providers focus on paying for outcomes rather than doctor patient episodes, pharmaceutical companies also face increased scrutiny of how much benefits patients get from drug treatments. Agencies like NICE in the UK are closely examining the value based assessment (reimbursements) models which pay only when drugs act on individual patients and help improve their life. The British government is also considering care.data initiative which will link the hospital treatment data with General Physician lead ambulatory data and create a complete patient profile to understand whether (and how) drugs are working in patients.
- Industry Collaborative Developments: Multiple organisations are working to accelerate the promise of personalized medicine. SAP for instance is collaborating with the German National Centre for Tumour Disease to enable quick access and analysis of the vast cancer data. Similarly IBM is focusing on healthcare (most prominently through its IBM Watson technology) and is also in collaboration with personalized medicine firms like Coriell Life sciences by helping in analysis of big data.
- Patient lead demand: Consumerism is finally arriving in Healthcare with patients now demanding more choice and involvement in their treatment. Popularity of wearables in healthcare (Nike+, Fitbit, Jawbone etc), remote patient monitoring (and various telemedicine initiatives) and the wide variety of information generated by the mobile phones are just some of the factors facilitating consumerism.
However major challenges still remain with regards to privacy of patient data, lack of clear government policy directives and limitations of technology to present real time genomic analysis for instant decision making to the healthcare practitioners at the point of care.
Low hanging fruits will be found in oncology and cancer treatments, but a wider proliferation is approaching fast.
What do you think ?